Provider Demographics
NPI:1700044328
Name:METRO ANESTHESIA & PAIN SERVICES PC
Entity Type:Organization
Organization Name:METRO ANESTHESIA & PAIN SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-342-0004
Mailing Address - Street 1:1340 SLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3021
Mailing Address - Country:US
Mailing Address - Phone:251-342-0004
Mailing Address - Fax:251-343-7704
Practice Address - Street 1:1340 SLEDGE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3021
Practice Address - Country:US
Practice Address - Phone:251-342-0004
Practice Address - Fax:251-343-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4239208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529000330Medicaid
ALC71607Medicare UPIN